male sitting on floor drinking from whisky bottle

How Substance Abuse Can Lead to Dissociation

Posted on April 16th, 2018

When Alan was small, his alcoholic father verbally and physically abused him. He never knew when the belt would come down. He lived in fear of those nights when his dad would come home upset about work. That’s always when he got hurt the most.

To cope with the unbearable physical and emotional pain, he created his own special planet in the backyard. When he was hurting, he’d sit on a lounge chair out back and look up at the sky, and imagined there was an alien, like Superman, who would come and save him and take him away.

Imagining this special savior allowed him to pretend it wasn’t him getting beaten when the strap came down. It worked when he was a kid. But when he got into his teens and no one came to save him, he began drinking to quell the pain.

Dissociation Gets Us Through Bad Times

Until he went to drug rehab, Alan didn’t realize he was drinking to cope with the pain of his dad’s alcoholism. He also learned that his emotional escape was what mental health professionals called “dissociation.” Dissociation gets people through difficult times, but it can become a problem or disorder unto itself.

“Dissociation is a very common response to trauma which can occur while the trauma is happening and can continue to occur for years after the trauma ended,” says Catherine Silver, LCSW, a New York City psychotherapist specializing in the treatment of eating disorders, trauma and addiction. “When a person experiences trauma, their brain goes into a protective mode where it detaches from what is happening at the moment. The person might experience a type of blackout during the trauma, or they might feel like they are watching it happen to them. The point is that our survival instincts kick in to create distance from the trauma.”

Following trauma, some people turn to alcohol or drug use (or other addictive behaviors, like disordered eating, compulsive shopping, gambling or sex) as a way to cope. Ultimately these behaviors serve the same purpose of creating distance from something that is very painful.

Common Ways People Dissociate

Dissociation manifests in three common ways, says Silver:

1. Not being able to remember critical pieces of an event or whole chunks of time. Sometimes people can’t remember certain years (for example, having no memories from a specific year).

2. Having blackout experiences, where someone doesn’t remember anything about how they got to where they are. Sometimes this happens in a less intense way and life happens as if you’re on autopilot. “Think about times when you drive somewhere and after you arrive you realize you don’t remember anything from the drive,” says Silver.

3. Feeling fuzzy or foggy, as if you’re seeing the world through a fishbowl.

Dissociation is considered a defense mechanism that allows people under stress to separate from the normal flow of consciousness. For example, when Alan would sit out in the backyard, waiting for a friendly alien to come and take him away, he would pretend that he lived on another planet. He would see a spaceship in his mind’s eye and believed it was going to take him to his real home. “Sometimes our brain compartmentalizes trauma so well that it feels like it happened to a different person,” explains Silver.

In some cases, repression of the event is a special kind of dissociation that occurs to allow people who’ve been subjected to overwhelming trauma to avoid the associated feelings. It allows them to “forget” awful things they have been through for a time. The danger is that these feelings and memories can return unexpectedly and when people are in a vulnerable state. They also might experience “reliving” the moment. That’s why it is so important to unearth the trauma that leads to dissociation so that the person can gain better control.

When Trauma Leads to Substance Abuse

As was the case with Alan, childhood trauma can lead to trying to self-soothe through the use of alcohol, drugs or other addictive processes such as sex or gambling. Growing up in an alcoholic family can be a traumatic event in itself. Research shows that substance abuse can create additional trauma, which can lead to new or continued episodes of dissociative behavior.

Sex addicts are often characterized as having the ability to compartmentalize their lives but research shows this is a form of dissociation. In a study of sex addicts, family and friends described the addicted loved one as being like “Dr. Jekyll and Mr. Hyde.” In a survey of 31 inpatient self-identified sex addicts, two-thirds of those interviewed were identified as having a dissociative disorder.

“What can become problematic is when our brains, again automatically, react in the same way in response to something that reminds a person of the traumatic event,” says Silver. “For example, someone might hear a loud noise or be in a large group of people ― or anything else that reminds them of the trauma, such as a smell or taste ― and while they rationally know they’re not in danger, the survival part of their brain is reminded of the trauma and reacts.”

It’s not a conscious decision to dissociate or not. “Sometimes it’s the only way our brains instinctively know how to get through the traumatic event,” says Silver. “It’s about survival and getting through the event in the ‘safest’ way possible.” That’s why it’s so important to work on unearthing the original trauma and healing the addiction that may have formed to try to quell the pain.

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